中老年人血清25-羟基维生素D水平与老年性白内障发生的相关性分析
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摘要
目的探讨中老年人血清25-羟基维生素D[25-(OH)-D]水平与老年性白内障(senile cataract,SC)发生的相关性。方法采用横断面调查,选取2017年5月至2018年5月在运城市眼科医院门诊体检的400例45岁以上中老年人为研究对象。采用自制调查表收集其SC患病情况等临床资料,以Cobas 6000 e601型电化学发光仪(瑞士罗氏公司)测定25-(OH)-D水平。通过Spearman或Pearson相关性分析血清25-(OH)-D水平与临床资料或临床指标的相关性,Logistic回归分析SC发生的相关影响因素。结果相关性分析显示:血清25-(OH)-D水平与男性、户外光暴露时间均呈正相关性(均为P<0.05),与年龄、吸烟和饮酒均呈负相关性(均为P<0.05)。Logistic回归分析表明,与SC发生相关的影响因素包括性别、年龄、高血压、糖尿病、低密度脂蛋白水平、长时间太阳光暴露和血清25-(OH)-D水平(均为P<0.05);而血清25-(OH)-D水平与SC发生呈负相关(OR=0.77,95%CI:0.61-0.89,P<0.05)。结论长时间太阳光暴露和25-(OH)-D缺乏可能与SC的发生有关,适当的阳光照射或补充维生素D有助于预防和改善SC的发生和进展。
Objective To study the relationship between serum 25-hydroxyvitamin D [25-(OH)-D] level and senile cataract(SC) in middle-aged and aged population.Methods The cross-sectional study was undertaken on 400 middle-aged and aged outpatients(age >45 years) participated in the physical examination in Yuncheng Eye Hospital during May,2017 to May,2018.The clinical information,such as the status of SC,was collected by self-designed questionnaires.Serum 25-(OH)-D level was detected by Roche Cobas e601 automatic electrochemical luminescence immunoassay analyzer.Spearman or Pearson correlation analysis was used to analyze the relationship between serum 25-(OH)-D and clinical date or clinical indexes.The influence factors associated with SC were analyzed by Logistic regression analysis.Results Correlation analysis showed that the serum 25-(OH)-D level was positively correlated with male,and long sun exposure time(both P<0.05),and negatively correlated with age,smoke status and alcohol consumption(all P<0.05).Logistic regression analysis showed the influence factors associated with SC including gender,age,hypertension,diabetes,low density lipoprotein level,long sun exposure time and serum 25-(OH)-D level(all P<0.05),and the inverse correlation between serum 25-(OH)-D level and SC(OR=0.77,95%CI:0.61-0.89,P<0.05).Conclusion The long sun exposure time and 25-(OH)-D deficiency may be relevant to the occurrence of SC.Appropriate sun exposure or vitamin D supplements may help to prevent the development and progression of SC.
Objective To study the relationship between serum 25-hydroxyvitamin D [25-(OH)-D] level and senile cataract(SC) in middle-aged and aged population.Methods The cross-sectional study was undertaken on 400 middle-aged and aged outpatients(age >45 years) participated in the physical examination in Yuncheng Eye Hospital during May,2017 to May,2018.The clinical information,such as the status of SC,was collected by self-designed questionnaires.Serum 25-(OH)-D level was detected by Roche Cobas e601 automatic electrochemical luminescence immunoassay analyzer.Spearman or Pearson correlation analysis was used to analyze the relationship between serum 25-(OH)-D and clinical date or clinical indexes.The influence factors associated with SC were analyzed by Logistic regression analysis.Results Correlation analysis showed that the serum 25-(OH)-D level was positively correlated with male,and long sun exposure time(both P<0.05),and negatively correlated with age,smoke status and alcohol consumption(all P<0.05).Logistic regression analysis showed the influence factors associated with SC including gender,age,hypertension,diabetes,low density lipoprotein level,long sun exposure time and serum 25-(OH)-D level(all P<0.05),and the inverse correlation between serum 25-(OH)-D level and SC(OR=0.77,95%CI:0.61-0.89,P<0.05).Conclusion The long sun exposure time and 25-(OH)-D deficiency may be relevant to the occurrence of SC.Appropriate sun exposure or vitamin D supplements may help to prevent the development and progression of SC.
引文
[1] KEEL S,HE M.Risk factors for age-related cataract[J].Clin Exp Ophthalmol,2018,46(4):327-328.
[2] ZU S Y,XIANG R W.Dosing time of levofloxacin eye drops in the perioperative period of senile cataract[J].Chin Hosp Pharm J,2017,37(24):2479-2481.祖嵩洋,项荣武.老年性白内障围手术期预防性应用左氧氟沙星滴眼液不同给药时机的临床观察[J].中国医院药学杂志,2017,37(24):2479-2481.
[3] SONG P,WANG H,THEODORATOU E,CHAN K Y,RUDAN I.The national and subnational prevalence of cataract and cataract blindness in China:a systematic review and meta-analysis[J].J Glob Health,2018,8(1):010804.
[4] YANG Y J,XIANG Y H.Association of 25-hydroxyvitamin D with dry eye[J].Rec Adv Ophthalmol,2017,37(12):1165-1168.杨玉洁,相义会.25-羟基维生素D与干眼的相关性研究[J].眼科新进展,2017,37(12):1165-1168.
[5] LI J,YAN Y J,YAO B D,WANG W J,ZHANG Y H,FANG H.The relationship between serum vitamin D and diabetic retinopathy in patients with type 2 diabetes mellitus[J].Fudan Univ J Med Sci,2017,44(5):580-584,601.李俊,严玉洁,姚保栋,王伟杰,张颖华,方红.血清维生素D与2型糖尿病视网膜病变关系的研究[J].复旦大学学报(医学版),2017,44(5):580-584,601.
[6] WANG Z Y,HUANG M Y,LI Q H.756 cases of age-related cataracts in elderly patients and its influence factors[J].Pract Prev Med,2017,24(12):1502-1504.王兆堰,黄梦运,李秋惠.756例老年人年龄相关性白内障发生情况及其影响因素研究[J].实用预防医学,2017,24(12):1502-1504.
[7] TANG Y,WANG X,WANG J,JIN L,HUANG W,LUO Y,et al.Risk factors of age-related cataract in a Chinese adult population:the Taizhou Eye Study[J].Clin Exp Ophthalmol,2018,46(4):371-379.
[8] GONG Y,FENG K,YAN N,XU Y,PAN C W.Different amounts of alcohol consumption and cataract:a meta-analysis[J].Optom Vis Sci,2015,92(4):471-479.
[9] SU Z,NARLA S N,ZHU Y.25-Hydroxyvitamin D:analysis and clinical application[J].Clin Chim Acta,2014,433:200-205.
[10] LI X C,LIN Y M,HUANG C L.Survey analysis of 1137 cases of serum 25-hydroxyvitamin D levels[J].J Med Theor Prac,2017,30(20):3111-3112.李新才,林玉梅,黄超林.1137例血清25-羟基维生素D水平调查分析[J].医学理论与实践,2017,30(20):3111-3112.
[11] WU F,BIAN P D,YING Q F.The association between serum 25-hydroxyvitamin D and basking in elderly men[J].Zhejiang Clin Med J,2016,18(11):2004-2005.吴芬,边平达,应奇峰.老年男性晒太阳与其血清25-羟基维生素D的相关性[J].浙江临床医学,2016,18(11):2004-2005.
[12] LAROSE T L,CHEN Y,CAMARGO C A,LANGHAMMER A,ROMUNDSTAD P,MAI X M.Factors associated with vitamin D deficiency in a Norwegian population:the HUNT Study[J].J Epidemiol Commun Health,2014,68(2):165-170.
[13] LU Z Q,YAN J,SUN W H,JIANG T X,ZHANG D,ZHAI S N,et al.Influence of fruit and vegetable intake on age-related cataract[J].Int Eye Sci,2012,12(1):58-61.
[14] LIN S N,CHEN S.Advances in pathogenesis and traditional Chinese medicine treatment of senile cataract[J].Med Recapitul,2017,23(5):997-1000.林淑娜,陈胜.老年性白内障的发病机制和中医药治疗进展[J].医学综述,2017,23(5):997-1000.
[15] PARK S,CHOI N K.Serum 25-hydroxyvitamin D and age-related cataract[J].Ophthalmic Epidemiol,2017,24(5):281-286.
[16] SELIN J Z,LINDBLAD B E,RAUTIAINEN S,MICHA?LSSON K,MORGENSTERN R,BOTTAI M,et al.Are increased levels of systemic oxidative stress and inflammation associated with age-related cataract[J].Antioxid Redox Signal,2014,21(5):700-704.
[17] TONIATO E,SPINAS E,SAGGINI A,KRITAS S K,CARAFFA A,ANTINOLFI P,et al.Immunomodulatory effects of vitamin D on skin inflammation[J].J Biol Regul Homeost Agents,2015,29(3):563-567.
[18] YAN S B,LIU Z X.Study on factors related to cataract in middle-aged and elderly people[J].Anhui Med Pharm J,2015,19(5):932-934.颜少彪,刘忠鑫.中老年人群发生白内障的相关因素研究[J].安徽医药,2015,19(5):932-934.
[19] JIANG W T,LIU P.Research progress of drugs that can control and prevent age-related cataract[J].Int Eye Sci,2017,17(2):243-246.
[2] ZU S Y,XIANG R W.Dosing time of levofloxacin eye drops in the perioperative period of senile cataract[J].Chin Hosp Pharm J,2017,37(24):2479-2481.祖嵩洋,项荣武.老年性白内障围手术期预防性应用左氧氟沙星滴眼液不同给药时机的临床观察[J].中国医院药学杂志,2017,37(24):2479-2481.
[3] SONG P,WANG H,THEODORATOU E,CHAN K Y,RUDAN I.The national and subnational prevalence of cataract and cataract blindness in China:a systematic review and meta-analysis[J].J Glob Health,2018,8(1):010804.
[4] YANG Y J,XIANG Y H.Association of 25-hydroxyvitamin D with dry eye[J].Rec Adv Ophthalmol,2017,37(12):1165-1168.杨玉洁,相义会.25-羟基维生素D与干眼的相关性研究[J].眼科新进展,2017,37(12):1165-1168.
[5] LI J,YAN Y J,YAO B D,WANG W J,ZHANG Y H,FANG H.The relationship between serum vitamin D and diabetic retinopathy in patients with type 2 diabetes mellitus[J].Fudan Univ J Med Sci,2017,44(5):580-584,601.李俊,严玉洁,姚保栋,王伟杰,张颖华,方红.血清维生素D与2型糖尿病视网膜病变关系的研究[J].复旦大学学报(医学版),2017,44(5):580-584,601.
[6] WANG Z Y,HUANG M Y,LI Q H.756 cases of age-related cataracts in elderly patients and its influence factors[J].Pract Prev Med,2017,24(12):1502-1504.王兆堰,黄梦运,李秋惠.756例老年人年龄相关性白内障发生情况及其影响因素研究[J].实用预防医学,2017,24(12):1502-1504.
[7] TANG Y,WANG X,WANG J,JIN L,HUANG W,LUO Y,et al.Risk factors of age-related cataract in a Chinese adult population:the Taizhou Eye Study[J].Clin Exp Ophthalmol,2018,46(4):371-379.
[8] GONG Y,FENG K,YAN N,XU Y,PAN C W.Different amounts of alcohol consumption and cataract:a meta-analysis[J].Optom Vis Sci,2015,92(4):471-479.
[9] SU Z,NARLA S N,ZHU Y.25-Hydroxyvitamin D:analysis and clinical application[J].Clin Chim Acta,2014,433:200-205.
[10] LI X C,LIN Y M,HUANG C L.Survey analysis of 1137 cases of serum 25-hydroxyvitamin D levels[J].J Med Theor Prac,2017,30(20):3111-3112.李新才,林玉梅,黄超林.1137例血清25-羟基维生素D水平调查分析[J].医学理论与实践,2017,30(20):3111-3112.
[11] WU F,BIAN P D,YING Q F.The association between serum 25-hydroxyvitamin D and basking in elderly men[J].Zhejiang Clin Med J,2016,18(11):2004-2005.吴芬,边平达,应奇峰.老年男性晒太阳与其血清25-羟基维生素D的相关性[J].浙江临床医学,2016,18(11):2004-2005.
[12] LAROSE T L,CHEN Y,CAMARGO C A,LANGHAMMER A,ROMUNDSTAD P,MAI X M.Factors associated with vitamin D deficiency in a Norwegian population:the HUNT Study[J].J Epidemiol Commun Health,2014,68(2):165-170.
[13] LU Z Q,YAN J,SUN W H,JIANG T X,ZHANG D,ZHAI S N,et al.Influence of fruit and vegetable intake on age-related cataract[J].Int Eye Sci,2012,12(1):58-61.
[14] LIN S N,CHEN S.Advances in pathogenesis and traditional Chinese medicine treatment of senile cataract[J].Med Recapitul,2017,23(5):997-1000.林淑娜,陈胜.老年性白内障的发病机制和中医药治疗进展[J].医学综述,2017,23(5):997-1000.
[15] PARK S,CHOI N K.Serum 25-hydroxyvitamin D and age-related cataract[J].Ophthalmic Epidemiol,2017,24(5):281-286.
[16] SELIN J Z,LINDBLAD B E,RAUTIAINEN S,MICHA?LSSON K,MORGENSTERN R,BOTTAI M,et al.Are increased levels of systemic oxidative stress and inflammation associated with age-related cataract[J].Antioxid Redox Signal,2014,21(5):700-704.
[17] TONIATO E,SPINAS E,SAGGINI A,KRITAS S K,CARAFFA A,ANTINOLFI P,et al.Immunomodulatory effects of vitamin D on skin inflammation[J].J Biol Regul Homeost Agents,2015,29(3):563-567.
[18] YAN S B,LIU Z X.Study on factors related to cataract in middle-aged and elderly people[J].Anhui Med Pharm J,2015,19(5):932-934.颜少彪,刘忠鑫.中老年人群发生白内障的相关因素研究[J].安徽医药,2015,19(5):932-934.
[19] JIANG W T,LIU P.Research progress of drugs that can control and prevent age-related cataract[J].Int Eye Sci,2017,17(2):243-246.